Prostate Cancer Screening: Not Worth The Money?

There’s been quite a shift in official recommendations regarding the popular PSA blood test. As most men know, this is by far the most popular screening test for prostate cancer. The problem, as I’ve mentioned before, is that the PSA test is not only poor at finding real cancers, it’s also bad at creating many falsely positive tests. This leads to many unnecessary follow-up biopsies, not to mention treatments and surgeries that leave many men impotent or with difficulties urinating.

There have been a slew of new medical reviews which do question the usefulness of the PSA and strongly encourage more discussion between patients and their doctors as to whether or not they should get the PSA. Now, there’s a very interesting op-ed piece from Richard Ablin, the scientist who discovered the PSA test in the 1970’s, who comes out strongly against the PSA test. It’s an eloquent and readable synopsis of the main issues. Here’s a snippet:

I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of P.S.A. screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.

I definitely agree that this PSA test is by far a perfect test, and men should not automatically get this test — certainly not without a long discussion with their doctor about its risks and benefits. Unfortunately, diagnosing prostate cancer is still difficult — but at least men can be reassured that most of these cancers are very slow growing. Indeed, there is a growing push for initially just “watchful waiting” for men with prostate cancer, instead of rushing into surgery.